Medical Journal of the Islamic Republic Of Iran

en Exploring Dental Caries and Associated Factors in 3-Year-Old Iranian Children: An Application of Random Forest for Zero-Inflated Poisson Process Dentistry Dentistry Original Research Original Research     Background: Dental caries, caused by bacterial activity leading to tooth decay, has a profound impact on children's quality of life. This study aimed to investigate factors associated with dental caries in 3-year-old Iranian children.    Methods: A cross-sectional study was conducted involving 815 three-year-old children who were referred to healthcare centers in the southern region of Tehran Province, Iran. Truncated random forest, traditional random forest, and a log-linear model were employed, utilizing the number of dental caries (including excess zeros) as the outcome variable. Predictors included sex, tooth brushing, dental flossing, sweet consumption, dental visits, and parental education level.    Results: The log-linear model's rate ratio (RR) indicated that boys were more likely to have at least 1 decayed tooth compared to girls (RR, 1.11). Dental floss usage significantly reduced childhood dental caries (RR, 2.74). Variable importance analysis from 2 random forests identified dental floss usage, dental visits, and the father’s educational level as the most impactful factors on childhood caries. Results based on mean squared error (MSE) demonstrated that the truncated random forest (MSE, 0.002) outperformed the log-linear model (MSE, 0.959) and exhibited similar performance to the traditional random forest model (MSE, 0.006).    Conclusion: The truncated random forest model demonstrated superior performance compared to traditional random forest and log-linear models. From a clinical perspective, promoting knowledge and practices related to good oral health habits in parents and their children emerges as a crucial strategy for reducing the risk of childhood caries.   Childhood Caries, Random Forests, Zero-Inflated Outcome, Poisson Process 441 446 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-9306-1&slc_lang=en&sid=1 Fatemeh Masaebi fatemeh.masaebi71@gmail.com 200319475328460091324 200319475328460091324 No Social Determinants of Health Research Center, Health and Metabolic Diseases Research Institute, Zanjan University of Medical Sciences, Zanjan, Iran Masoud Salehi salehi7@yahoo.com 200319475328460091325 200319475328460091325 No Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran Zahra Ghorbani dryaszgh@yahoo.com 200319475328460091326 200319475328460091326 No Community Oral Health Department, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mehdi Azizmohamad Looha mehdi.looha@gmail.com 200319475328460091327 200319475328460091327 No Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran Morteza Mohammadzadeh morteza0763@gmail.com 200319475328460091328 200319475328460091328 No Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran Marzie Deghatipour fatemeh.mb71@yahoo.com 200319475328460091329 200319475328460091329 No Community Oral Health Department, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran Denis Larocque denis.larocqe@hec.ca 200319475328460091330 200319475328460091330 No Department of Decision Sciences, HEC Montréal, 3000 chemin de la Côte–Sainte–Catherine, Montréal, Québec, Canada Farid Zayeri fzayeri@gmail.com 200319475328460091331 200319475328460091331 Yes Proteomics Research Center and Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran